Configuration Analyst

 
Position: Configuration Analyst

Job ID: 164800

Department: CONFIGURATION TEAM

Talent Area: Information Services

Full/Part Time: Full-Time

Regular/Temporary: Regular

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 14,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org. At Texas Children’s Hospital, diversity, equity, and inclusion are at the core of our values and mission for all of our patients and families that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Configuration Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for the activities related to system updates, new health plan implementations, and conversions within Business Operations. Designs configurations solutions to meet new business requirements and perform updates for either benefit, coding, contracts, fee schedules, or claim editing rules in adherence with business policies and state requirements. The configuration analyst should have strong knowledge in at least one of the areas under the purview of Med Policy Configuration:  benefits, contracting, coding, fees schedules, or claim edits (CES). 



Responsibilities :

Responsibility A: Performs daily configuration changes in claim adjudication systems 

  • Analyzes incoming requests and designs configuration solutions to meet business requirements 
  • Performs configuration changes for coding, contracts, benefits, fee schedules, and claim editing rules as needed 
  • Creates testing scenarios to demonstrate the efficiency of proposed configuration solutions 
  • Maintains thorough and concise documentation for tracking of all contracts, benefits, fee schedules, and claim editing rule changes related to Change Control Management or issues for quality audit purposes 
  • Executes configuration changes in an accurate and timely manner to meet the department’s standards for quality and service level agreements 
  • Assists with the development of configuration standards and best practices 
  • Identifies claims impacted by configuration changes done in the system and sends reports to the claims administration department for reprocessing 
  • Monitors pended claims and work queues to update appropriate systems. Responsible for escalating identified issues, making recommendations, and assisting with implementing configuration changes to improve the accuracy and efficiency of processes 
  • Handles fluctuating volumes of work and prioritizes work to meet deadlines and user needs of the Health Plan. 

Responsibility B: Performs system configuration design analysis associated with projects 

  • On receipt of a service ticket, analyze the request, and solution for the resolution 
  • Shares the solution with the Lead Configuration Analyst for feedback and approval 
  • Applies knowledge and experience to ensure all appropriate requirements have been provided 
  • Collaborate with the other team members to ensure that the documentation of user policies and procedures is updated timely as changes may occur 
  • Partner with end-users to determine specific requirements needed to increase configuration accuracy 

Responsibility C: Analyzes configuration errors and identifies required modifications 

  • Analyzes current configuration to identify and resolve errors 
  • Recommends modifications to configuration settings or current procedures to improve claims adjudication 
  • Documents issues, activities, and solutions employing standard methodology and utilities. 

Responsibility D: Supports new system implementations and upgrades Assist departmental leaders with upgrade testing as needed 

  • Communicates with management to address problems and resolutions 
  • Participates in training sessions with users to view new systems and upgrades 
  • Reviews and tests systems for conformance to functional and performance requirements 


Qualifications:

  • Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s unless approved for a medical or religious exemption.  
  • Required H.S. Diploma or GED with a preferred Bachelor's Degree 
  • 2 years Managed care, claims processing, and/or configuration of benefits/contracts/fee schedules/medical policy payment rules experience 


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